2025-02-06T15:45:46+00:00 2024-03-31 440160260 Forvis Mazars LLP 1551 N Waterfront Pkwy Ste 300 Wichita KS 672066601 990 2023-04-01 481226830 GREAT PLAINS OF SMITH CO INC GREA 7852826845 PO BOX 349 SMITH CENTER KS 66967 CURT COLSON PRESIDENT/CEO 3166851523 2025-02-06 true true Michael Engle P00482834 3162652811 2025-02-06 2023 2025-03-06 01:10:19Z SMITH COUNTY MEMORIAL HOSPITAL CURT COLSON 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 24921452 false X WWW.SCMHKS.ORG X 1999 KS THE OPERATION OF HOSPITAL FACILITIES FOR THE DELIVERY OF HEALTH CARE SERVICES, EDUCATION, AND WELLNESS WITHOUT REGARD TO RACE, CREED, COLOR, SEX OR FINANCIAL CIRCUMSTANCE. 6 5 183 7 0 0 1012270 240325 22899322 24097562 92924 372781 199599 210784 24204115 24921452 0 0 0 0 11188679 12312200 0 0 0 14262704 14160142 25451383 26472342 -1247268 -1550890 33511448 32530756 28646580 29059075 4864868 3471681 TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, HEALTH-RELATED EDUCATION, AS WELL AS THE PROMOTION OF HEALTH AND WELLNESS, WITHOUT REGARD TO RACE, CREED, COLOR, SEX OR FINANCIAL CIRCUMSTANCE. false false 22496366 0 24132992 GREAT PLAINS OF SMITH COUNTY, INC., DBA SMITH COUNTY MEMORIAL HOSPITAL, DELIVERS PRIMARY HEALTH CARE SERVICES TO RESIDENTS IN AN AREA THAT INCLUDES SMITH COUNTY, KANSAS. THE SERVICE AREA ALSO INCLUDES, TO A LESSER DEGREE, PHILLIPS, JEWELL, AND OSBORNE COUNTIES IN KANSAS, AS WELL AS FRANKLIN AND WEBSTER COUNTIES IN NEBRASKA. THE PRIMARY HEALTHCARE SERVICES ARE DELIVERED THROUGH A CRITICAL ACCESS HOSPITAL AND A PROVIDER-BASED RURAL HEALTH CLINIC. THE RURAL HEALTH CLINIC SERVED 15,307 PATIENTS FROM 41 ZIPCODES. SEE SCHEDULE O FOR CONTINUATION. 22496366 true true false true false false false false true true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false true false true 22 0 true 183 true false false false false false false false false false false false false X 6 5 true false false false true true true true true false false true true true true true true false false false X JASON BARB 3166851523 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 CURT COLSON PRESIDENT/CEO 0.2 41.2 X X 0 217359 54774 JOHN TERRILL CHAIRMAN/DIRECTOR 0.2 1.2 X X 0 0 0 ROGER JOHN SECRETARY/DIRECTOR 0.2 1.2 X X 0 0 0 STEVE CARLSON TREASURER/DIRECTOR 0.2 1.2 X X 0 0 0 ARTHUR HENDRICKSON DIRECTOR 0.2 1.2 X 0 0 0 CHARLES WESTIN DIRECTOR (LEFT 5/23) 0.2 1.2 X 0 0 0 DR BARBARA BROWN APPLEGATE DIRECTOR 0.2 1.2 X 0 0 0 ALLEN VANDRIEL ADMINISTRATOR 40.0 0.0 X 195657 0 42486 JASON BARB CFO 0.2 41.2 X 0 191413 50658 SARAH RAGSDALE Administrator 40.0 0.0 X 124848 0 26280 STEPHEN LEWIS CFO 40.0 0.0 X 140349 0 36941 FERRILL CONANT PHYSICIAN 40.0 0.0 X 269755 0 47151 HANNAH HAACK PHYSICIAN 40.0 0.0 X 343732 0 64944 JUSTIN OVERMILLER PHYSICIAN 40.0 0.0 X 323187 0 62030 LEAH WIEHL PHYSICIAN 40.0 0.0 X 171370 0 40570 STEPHEN MOLL PHYSICIAN 40.0 0.0 X 264027 0 59463 1832925 408772 485297 23 false true false GPHA 250 N ROCK RD STE 160 WICHITA KS 67206 BILLING SERVICE/MGMT 1401295 HOLISTIC PAIN MANAGEMENT 3780 N GARFIELD LOVELAND CO 80538 PAIN MGMT SERVICE 767290 MIDWEST ANESTHESIA ALLIANCE PO BOX 306 MEMPHIS MO 63555 CRNA SERVICES 448942 AYA HEALTHCARE INC PO Box 123519 Dept 3519 Dallas TX 75312 Nurse Staffing 203068 WOUND CARE SPECIALISTS PO BOX 71849 CHICAGO IL 606941849 WOUND CARE 193900 11 11664 228661 240325 NET PATIENT SERVICE REVENUE 621300 20939663 20939663 340B PRESCRIPTION DRUG REVENUE 621300 3157899 3157899 0 0 0 0 24097562 369781 369781 6005 6005 0 6005 6005 3000 0 0 3000 3000 3000 EMPLOYEE/GUEST MEALS 722513 115475 115475 MEALS ON WHEELS 722513 35430 35430 VENDOR REBATES 900099 27287 27287 26587 0 0 26587 204779 24921452 24132992 0 548135 X 569187 569187 9060091 8235145 824946 721984 644704 77280 1305252 1083178 222074 655686 560901 94785 139688 139688 3045 3045 200847 200847 4120 4120 4839662 4083034 756628 0 38612 38612 495470 457831 37639 36040 17624 18416 474626 355796 118830 9676 6422 3254 105760 65791 39969 730038 547261 182777 2097828 1572602 525226 235314 176399 58915 MEDICAL SUPPLIES 4457399 4457399 EQUIPMENT RENTAL/MAINTENANCE 194877 167948 26929 DUES & SUBSCRIPTIONS 64100 31291 32809 ALL OTHER EXPENSES 33040 33040 0 0 0 0 26472342 22496366 3975976 0 3816889 164148 4421743 8819386 2567448 2970841 0 0 0 0 329031 259103 179609 228108 31293012 13071210 20090704 18221802 0 0 2106024 1867368 33511448 32530756 2593159 2844585 0 0 26018121 25490809 35300 723681 28646580 29059075 X 3908767 2333958 956101 1137723 4864868 3471681 33511448 32530756 -1550890 157703 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4120 4120 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. 956098 106971 178743 104092 1137720 985545 46808 -64148 12107 956098 972031 171687 8634 166807 985545 877459 66240 93680 65348 972031 936018 13269 -38761 33067 877459 0.0 0.9041 0.0959 true false 395701 395701 19602101 6810424 12791677 6943803 4540480 2403323 4351407 1720306 2631101 18221802 FUNDS HELD BY ESCROW AGENT 1677731 OTHER RECEIVABLES 189637 1867368 DUE TO THIRD PARTY 723681 723681 Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. Schedule D, Part V, Line 4 Intended uses of endowment funds THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO SUPPORT THE CONTINUING OPERATIONS OF THE REPORTING ORGANIZATION. true true X true X false true true false true true 34149 34149 0.0013 1747190 1063048 684142 0.0258 0 0.0 0 0 1781339 1063048 718291 0.0271 90006 90006 0.0034 0 0.0 0 0.0 0 0.0 0 0.0 0 0 90006 0 90006 0.0034 0 0 1871345 1063048 808297 0.0305 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 521360 1063048 1747190 -684142 X true true 1 1 GREAT PLAINS OF SMITH CO INC 921 E HWY 36 SMITH CENTER KS 66967 WWW.SCMHKS.ORG H092001 X X X X RURAL HEALTH CLINIC GREAT PLAINS OF SMITH CO INC 1 false false true X X X X X X X X X 21 true false false true X https://www.scmhks.org/about-us/community-health-needs-assessment/ X true 21 true https://www.scmhks.org/about-us/community-health-needs-assessment/ false true X 200.0 X X X true true X X X X true X HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/ X HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/ X HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE HOSPITAL FACILITY ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAS PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - GREAT PLAINS OF SMITH CO, INC. THE OBJECTIVE OF THE SMITH COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS TO DETERMINE HEALTH NEEDS FROM THE PERSPECTIVE OF THE COMMUNITY IN COLLABORATION WITH THE HEALTH CARE PROVIDERS IN THE COMMUNITY. PARTICIPANTS IN A TOWN HALL MEETING HELD AS PART OF THE CHNA INCLUDED COMMUNITY RESIDENTS, GOVERNMENTAL, CIVIC, AND BUSINESS LEADERS IN THE COMMUNITY. THE ATTENDANCE ROSTER CAN BE FOUND IN SECTION V OF THE CHNA DOCUMENT. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - GREAT PLAINS OF SMITH CO, INC. THE CHNA CONDUCTED IN APRIL 2021 HIGHLIGHTED 10 ISSUES FOR SMITH COUNTY. THE ISSUES WERE: 1. DENTAL SERVICES 2. MENTAL HEALTH (DIAGNOSIS, PLACEMENT, AFTERCARE) 3. CHRONIC DISEASE MANAGEMENT 4. HOUSING 5. SPECIALITY SERVICES (OPTOMETRY AND PODIATRY) 6. AFFORDABLE INSURANCE/ACCESS TO MEDICAID 7. OBESITY (ACCESS TO EXERCISE) 8. DRUG & SUBSTANCE ABUSE 9. CHILD CARE 10. NURSING HOME/SENIOR CARE THE ISSUES IDENTIFIED WERE REVIEWED BY LEADERSHIP AND THE GOVERNING BOARD OF GREAT PLAINS OF SMITH COUNTY, INC. THEY WERE PRIORITIZED INTO AN IMPLEMENTATION PLAN, WHICH WAS PUBLISHED LATER IN 2021. THE CHNA REPORT, ALONG WITH THE IMPLEMENTATION PLAN ARE POSTED TO THE PUBLIC WEBSITE (WWW.SCMHKS.ORG). THE STRATEGY ADDRESSES EACH OF THE PRIORITIES IDENTIFIED, BUT ONLY TWO OF THE TEN ISSUES WERE RECOGNIZED AS BEING SOLELY WITHIN THE PURVIEW OF GREAT PLAINS OF SMITH COUNTY, INC. THOSE WERE ITEMS 3 AND 5. ITEMS 1, 2, 4, 6, 7, 8, 9, AND 10 WERE IDENTIFIED AS BEING ONLY ADDRESSABLE THROUGH A COLLABORATIVE APPROACH INVOLVING OTHER COMMUNITY PARTNERS. DURING THE INTERVAL BETWEEN COMPLETION OF THE CHNA AND THE END OF THE 2024 FISCAL YEAR, SIGNIFICANT PROGRESS WAS DEMONSTRATED IN ADDRESSING BOTH ITEM 3 AND 5. THE REMAINING 8 ISSUES ALSO HAD SIGNIFICANT PROGRESS DEMONSTRATED THROUGH COLLABORATION WITH OUTSIDE AGENCIES. 1 SMITH COUNTY FAMILY PRACTICE 921 E HWY 36 SMITH CENTER KS 66967 FAMILY PRACTICE Schedule H, Part I, Line 7 BAD DEBT EXCLUDED FOR PURPOSE OF CALCULATING COMMUNITY BENEFIT THE BAD DEBT EXPENSE IS NOT CONSIDERED A COMMUNITY BENEFIT EXPENSE AND IS NOT INCLUDED IN SCHEDULE H, PART I, LINE 7. THE AMOUNT EXCLUDED IS $521,360. Schedule H, Part VI ADDITIONAL DISCLOSURE REGARDING 501(R) DURING PREPARATION OF THE 2023 FORM 990, THE ORGANIZATION WAS ALERTED TO MINOR AND INADVERTENT ERRORS RELATED TO 501(R) COMPLIANCE. PRIOR TO FILING THE 2023 FORM 990, THE ORGANIZATION HAS ADDRESSED THE FOLLOWING DEFICIENCIES: - PROVIDER LISTS POSTED ONLINE, INCLUDING THOSE COVERED AND NOT COVERED BY THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, DID NOT HAVE AN UPDATED TIME STAMP REFLECTING THAT THEY HAD BEEN REVIEWED IN THE LAST THREE MONTHS. THE LISTS HAVE BEEN UPDATED AND ARE AVAILABLE ON THEIR WEBSITE AT THE FOLLOWING LOCATION: https://www.scmhks.org/services/financial-assistance-resources/. PAPER COPIES OF THE LISTINGS ARE ALSO AVAILABLE AT THE HOSPITAL'S REGISTRATION DESK. - FEDERAL POVERTY GUIDELINES HAVE BEEN UPDATED TO INCLUDE THE CURRENT YEAR AND FUTURE YEARS. FPG GUIDELINES ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE AT THE FOLLOWING LOCATION: https://www.scmhks.org/services/financial-assistance-resources/. - DURING QUARTERLY FINANCIAL CLOSE, STAFF WILL REVIEW THE WEBSITE AND MATERIALS AT THE REGISTRATION DESK TO ENSURE ALL REQUIRED DOCUMENTS, APPLICATIONS, AND POLICIES ARE AVAILABLE ELECTRONICALLY AND IN PAPER FORMAT. - DURING QUARTERLY FINANCIAL CLOSE, THE PROVIDER LISTINGS WILL BE REVIEWED AND UPDATED, INCLUDING AN UPDATED TIME AND DATE STAMP. - THE ORGANIZATION WILL CONTINUE TO IMPROVE LINES OF COMMUNICATIONS WITH THOSE RESPONSIBLE FOR WEBSITE MAINTENANCE AND PATIENT ACCOUNTS TO ENSURE THAT STAFF UNDERSTAND THE REQUIREMENTS OUTLINED IN THE 501(R) REGULATIONS. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDER INSURANCE STATUS. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE OF PART I, LINE 7 OF SCHEDULE H, IS A COST TO CHARGE RATIO. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASOBABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE APPLICABLE FOOTNOTE, NOTE 12, BEGINS ON PAGE 21 OF THE ATTACHED FINANCIAL STATEMENTS. Credit loss expense of $521,360 and $356,553 was recognized for the current fiscal year & prior year, respectively. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO. ANY SHORTFALL WOULD ARISE FROM PAYMENTS THAT ARE LESS THAN THE COSTS TO PROVIDE THE SERVICES. SHOULD A SHORTFALL OCCUR, IT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS IT MUST BE ABSORBED IN ORDER TO CONTINUE PROVIDING CARE TO OUR COMMUNITY. IT IS ALSO IMPLIED IN INTERNAL REVENUE SERVICE RULING 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS AND INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance ALL CHARITY CARE AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPTED FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. Schedule H, Part V, Section B, Line 16a FAP website - GREAT PLAINS OF SMITH CO, INC: Line 16a URL: HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/; Schedule H, Part V, Section B, Line 16b FAP Application website - GREAT PLAINS OF SMITH CO, INC: Line 16b URL: HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - GREAT PLAINS OF SMITH CO, INC: Line 16c URL: HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/; Schedule H, Part VI, Line 2 Needs assessment GREAT PLAINS OF SMITH COUNTY, INC. (GPSC) USES FORMAL AND INFORMAL METHODS TO DETERMINE THE NEEDS OF THE COMMUNITIES IT SERVES. OUTSIDE FACILITATORS HAVE BEEN USED TO ASSIST WITH FORMAL COMMUNITY HEALTH NEEDS ASSESSMENTS. THE FIRST OF THESE FORMAL ASSESSMENTS WAS COMPLETED IN 2012, FOLLOWED BY SUBSEQUENT ASSESSMENTS IN 2015, 2018 AND 2021. EACH OF THESE ASSESSMENTS INCLUDED SURVEYS MAILED TO MEMBERS OF THE COMMUNITY, FOLLOWED BY A PUBLIC FORUM DESIGNED TO GATHER INPUT IN AN INTERACTIVE FORMAT. FOLLOWING COMPLETION AND PUBLICATION OF EACH OF THE CHNAS, AN IMPLEMENTATION PLAN WAS DEVELOPED. IN 2021, THE SARS COV-2 PANDEMIC AND ITS IMPACT ON THE COMMUNITY AND ON PUBLIC GATHERINGS NECESSITATED A CHANGE IN TACTICS FOR THE FOURTH COMMUNITY HEALTH NEEDS ASSESSMENT. AFTER ANALYSIS OF THE SURVEYS AND THE PUBLIC INPUT, TEN AREAS OF COMMUNITY NEED WERE IDENTIFIED. THEY ARE OUTLINED IN THE CNHA DOCUMENT AND ARE ADDRESSED IN THE IMPLEMENTATION PLAN PUBLISHED IN 2022 AND UPDATED IN 2023. THE IMPLEMENTATION PLAN IS ATTACHED TO THIS SUMMARY. THE BOARD OF TRUSTEES OF SMITH COUNTY MEMORIAL HOSPITAL, WHICH CONSISTS OF FIVE MEMBERS APPOINTED BY THE SMITH COUNTY BOARD OF COMMISSIONERS, IS RESPONSIBLE FOR THE DELIVERY OF HEALTHCARE THROUGH SCMH. THE BOARD OF TRUSTEES HAS MAINTAINED A LEASE ARRANGEMENT WITH GREAT PLAINS HEALTH ALLIANCE (AND ITS PREDECESSOR, GREAT PLAINS LUTHERAN HOSPITALS) SINCE 1951. THIS LEASE ARRANGEMENT CREATES THE GREAT PLAINS OF SMITH COUNTY, INC. AS THE OPERATING ENTITY FOR THE DELIVERY OF SERVICES. THE BOARD OF TRUSTEES, ALTHOUGH NOT DIRECTLY INVOLVED IN THE GOVERNANCE OF THE DELIVERY SYSTEM, SERVE AS AN IMPORTANT CONDUIT FOR PUBLIC INPUT REGARDING THE NEEDS AND DELIVERY OF HEALTHCARE BY GREAT PLAINS OF SMITH COUNTY, INC. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance GREAT PLAINS OF SMITH COUNTY, INC. MAKES SIGNIFICANT EFFORTS TO PROVIDE INFORMATION TO THE PUBLIC REGARDING THE FUNCTION OF FEDERAL AND STATE PROGRAMS. WE USE FREQUENT SOCIAL MEDIA POSTS, NEWSPAPER ARTICLES, AND A BIANNUAL MAGAZINE TO PROVIDE INFORMATION ABOUT THE MEDICARE AND MEDICAID PROGRAMS, AND THE SERVICES THEY COVER. THE MAGAZINE-STYLE REPORT TO THE COMMUNITY HELPS TO EDUCATE THE COMMUNITY ABOUT PREVENTIVE HEALTH CARE, SERVICES AVAILABLE THROUGH GPSC, AND TOPICS RELATED TO INSURANCE PROGRAMS AVAILABLE IN THE COMMUNITY. DURING THE 2023 OPEN ENROLLMENT PERIOD FOR THE MEDICARE PROGRAM, GPSC UTILIZED THEIR OWN SHICK (SENIOR HEALTH INSURANCE FOR KANSAS) COUNSELOR WHO IS A LICENSED SOCIAL WORKER TO PROVIDE ONE ON ONE ASSISTANCE TO BENEFICIARIES. THESE MEETINGS ARE DESIGNED AS PURELY EDUCATIONAL TO ASSIST BENEFICIARIES IN SELECTING THE MOST BENEFICIAL MEDICARE RELATED PROGRAMS (ESPECIALLY SUPPLEMENTAL PLANS) DURING THE TIME WHEN THEY CAN MAKE THEIR ANNUAL SELECTION. OUR PATIENT CARE ADVOCATE, A LICENSED SOCIAL WORKER, PROVIDES INDIVIDUAL ASSISTANCE TO UNINSURED PATIENTS IN APPLICATION FOR COVERAGE UNDER THE KANCARE (KANSAS MEDICAID) PROGRAM. PATIENT ADVOCATE ALSO ASSISTS PATIENTS WITH THE INITIATION OF APPLICATIONS FOR FINANCIAL ASSISTANCE UNDER OUR CHARITY CARE PROGRAM. EVERY BILLING STATEMENT SENT TO PATIENTS CONTAINS INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM, INCLUDING INSTRUCTIONS ABOUT HOW TO INITIATE AN APPLICATION FOR ASSISTANCE. ADDITIONALLY, EVERY TELEPHONE CALL MADE TO PATIENTS REGARDING UNPAID BALANCES INCLUDES INFORMATION REGARDING THE OPTION TO APPLY FOR FINANCIAL ASSISTANCE. OUR FINANCIAL ASSISTANCE POLICY, ALONG WITH THE CONTACT IN FORMATION AND APPLICATION FORMS, IS ACCESSIBLE ON OUR PUBLIC WEBSITE. Schedule H, Part VI, Line 4 Community information THE 2020 UNITED STATES CENSUS REPORTED A TOTAL POPULATION IN SMITH COUNTY, KANSAS OF 3,570. THIS REPRESENTS A DECREASE OF 7.3% FROM THE 2010 CENSUS OF 3,853. THE POPULATION DENSITY IS APPROXIMATELY 4 PERSONS PER SQUARE MILE, CLASSIFYING THE COUNTY AS FRONTIER. APPROXIMATELY 96% OF THE POPULATION OF SMITH COUNTY IS REPORTED AS WHITE, WITH LESS THAN 1% EACH REPORTED AS BLACK, ASIAN, OR NATIVE AMERICAN. THE POPULATION IS NEARLY EVENLY DIVIDED BETWEEN MALE AND FEMALE. THE MEDIAN FAMILY INCOME IN SMITH COUNTY WAS REPORTED AS $43,429, COMPARED TO A NATIONAL MEDIAN OF $62,843. DESPITE THIS DISPARITY IN MEDIAN INCOME, THE CENSUS REPORTED 11.6% OF SMITH COUNTY RESIDENTS BEING BELOW THE POVERTY LEVEL, COMPARED TO 11.4% NATIONALLY. THIS INDICATES A HIGHER POPULATION IN THE LOW-MODERATE INCOME RANGE, BUT ABOVE THE POVERTY LEVEL. OF THE RESIDENTS LESS THAN 65 YEARS OF AGE IN SMITH COUNTY, 11.7% ARE REPORTED AS UNINSURED, COMPARED TO 10.2% NATIONALLY. THESE REPORTED NUMBERS ON UNINSURED LIKELY DO NOT REFLECT THE IMPACT OF THE COVID-19 PANDEMIC ON THE ECONOMY AND EMPLOYER-PROVIDED INSURANCE. Schedule H, Part VI, Line 5 Promotion of community health GREAT PLAINS OF SMITH COUNTY, INC. MAINTAINS AN OPEN MEDICAL STAFF, STRIVING FOR DIVERSITY TO REFLECT THE COMMUNITY AND SERVICE AREA. WE ADDED A TELEMEDICINE RHEUMATOLOGY AND ENDOCRINOLOGY CLINIC TO THE SPECIALTY CLINIC IN NOVEMBER 2023. THE ADDITION OF THESE CLINICS GAVE COMMUNITY MEMBERS ACCESS TO SPECIALISTS LOCALLY WITHOUT THE TRAVEL. THE UTILIZATION OF TELEHEALTH SERVICES TO EXPAND THE AVAILABILITY OF SERVICES, INCLUDING BEHAVIORAL HEALTH, HAVE SEEN SIGNIFICANT INCREASES IN USE DURING THE PAST YEAR. GREAT PLAINS OF SMITH COUNTY, INC. PARTNERED WITH HOLISTIC PAIN MANAGEMENT TO PROVIDE A PAIN MANAGEMENT CLINIC AND INCREASE AVAILABILITY OF PROCEDURES FOR PATIENTS WITH CHRONIC PAIN. THE SMITH COUNTY MEMORIAL HOSPITAL BOARD OF TRUSTEES, ALTHOUGH NOT DIRECTLY RESPONSIBLE FOR THE GOVERNANCE OF THE OPERATING ENTITY, NEVERTHELESS SERVES AS AN IMPORTANT LINK TO THE COMMUNITY. THE MEMBERSHIP OF THE BOARD OF TRUSTEES REPRESENTS THE GEOGRAPHIC DIVERSITY OF SMITH COUNTY, WITH MEMBERS APPOINTED TO REPRESENT VARIOUS REGIONS AND POPULATION CENTERS OF THE COUNTY. GREAT PLAINS OF SMITH COUNTY, INC. USES SIGNIFICANT EFFORTS TO PROMOTE THE HEALTH OF THE COMMUNITY. AMONG THESE EFFORTS ARE COMMUNICATION REGARDING HEALTHY LIFESTYLE, DISEASE PREVENTION AND DETECTION, AND COMMUNITY AWARENESS. WE USE SOCIAL MEDIA, OUR WEBSITE, RADIO AND TELEVISION ADVERTISING, AND NEWSPAPER ARTICLES AND ADVERTISING TO CONVEY IMPORTANT INFORMATION TO THE COMMUNITY. OTHER EFFORTS TO ENHANCE COMMUNITY EDUCATION INCLUDE STEPPING ON CLASSES OFFERED BY OUR EMERGENCY DEPARTMENT SUPERVISOR AND AN OCCUPATIONAL THERAPIST. THESE CLASSES, OFFERED TWICE PER YEAR IN VARIOUS LOCATIONS IN THE COUNTY, EMPHASIZE FALL PREVENTION THROUGH TECHNIQUES TO INCREASE BALANCE AND FLEXIBILITY TO OLDER RESIDENTS. THE TWO STAFF MEMBERS WHO TEACH THE CLASSES HAVE NOW BEEN ASKED TO SERVE AS STATEWIDE INSTRUCTOR TRAINERS IN AN EFFORT TO EXPAND THE AVAILABILITY OF THESE PROGRAMS IN OTHER COMMUNITIES. OTHER OFFERINGS INCLUDED ARE THE MEALS ON WHEELS PROGRAM, TELEHEALTH SERVICES, CARDIAC AND PULMONARY REHABILITATION PROGRAMS, AND EDUCATION PROGRAMS. THE MEALS ON WHEELS PROGRAM IS NOW COMPLETELY MANAGED BY GPSC, INCLUDING PREPARATION AND PACKAGING OF MEALS THAT ARE PROVIDED AT A DEEPLY DISCOUNTED COST TO HOMEBOUND MEMBERS OF THE COMMUNITY. GPSC HAS ALSO ASSUMED THE RESPONSIBILITY FOR SCHEDULING AND COORDINATING THE VOLUNTEER DELIVERY DRIVERS FOR THE MEALS, SUPPLEMENTED WHEN NECESSARY BY OUR PAID STAFF. ALTHOUGH ACCESS TO FACILITIES WAS LIMITED FOR A PERIOD OF TIME DUE TO THE PANDEMIC, THE CARDIAC REHABILITATION AND PULMONARY REHABILITATION PROGRAMS HAVE NOW RESUMED ACTIVITY, PROVIDING SERVICE TO GROWING NUMBERS OF BENEFICIARIES. EDUCATION PROGRAMS INCLUDE HEALTHY DIET PROGRAMS AND CHILDBIRTH EDUCATION PROGRAMS FOR EXPECTANT PARENTS. A COLLABORATIVE PROGRAM TO INCREASE SUPPORT SERVICES FOR BREASTFEEDING TO NEW MOTHERS WAS IMPLEMENTED IN 2022. THIS PROGRAM, A COLLABORATION BETWEEN GPSC HOSPITAL AND CLINIC STAFF, AS WELL AS STAFF FROM THE SMITH COUNTY HEALTH DEPARTMENT, SEEKS TO STANDARDIZE THE INFORMATION MADE AVAILABLE TO MOTHERS OF NEW BABIES. THE TRAINING FOR THE EMPOWER BEST PRACTICE BREASTFEEDING COLLABORATIVE WAS COMPLETED IN 2023. TRAINING AND CERTIFICATION PROGRAMS IN A VARIETY OF BASIC AND ADVANCED LIFESAVING TECHNIQUES. THESE INCLUDE BASIC LIFE SUPPORT (CPR), ADVANCED CARDIOVASCULAR LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, NEONATAL RESUSCITATION, TRAUMA NURSE CORE CURRICULUM, AND BASIC AND ADVANCED FETAL MONITORING COURSES ARE OFFERED BY INSTRUCTOR STAFF FROM OUR FACILITY. THE TARGET AUDIENCE FOR THESE CLASSES IS OUR OWN STAFF, AS WELL AS STAFF FROM NEIGHBORING COMMUNITIES. IN GENERAL, WHEN WE BECOME AWARE OF A NEED FOR ADDITIONAL SERVICES TO THE COMMUNITY AND SERVICE AREA, WE TAKE STEPS TO ASSURE DEVELOPMENT AND DELIVERY OF PROGRAMS TO ADDRESS THE NEEDS OF THE COMMUNITY. Schedule H, Part VI, Line 6 Affiliated health care system SMITH COUNTY MEMORIAL HOSPITAL IS OPERATED BY GREAT PLAINS OF SMITH CO., INC., A SUBSIDIARY OF GREAT PLAINS HEALTH ALLIANCE. GPHA IS A 501(C)(3) NOT FOR PROFIT ORGANIZATION WHICH PROVIDES MANAGEMENT, FINANCE, BILLING, INFORMATION SYSTEMS, AND PHARMACY SUPPORT SERVICES TO ITS AFFILIATED ORGANIZATIONS. GPHA DOES NOT PROVIDE SERVICES DIRECTLY TO PATIENTS, BUT PROVIDES ACCESS TO PROFESSIONALS AND SYSTEMS WHICH MIGHT NOT OTHERWISE BE AVAILABLE OR AFFORDABLE TO SMALL RURAL HOSPITALS. GPHA PROVIDES EDUCATION AND ASSISTANCE IN AREAS SUCH AS HIPAA PRIVACY AND SECURITY, MEDICARE AND MEDICAID REIMBURSEMENT RULES AND REGULATIONS, MEANINGFUL USE REQUIREMENTS FOR ELECTRONIC HEALTH RECORDS, ETC. GREAT PLAINS HEALTH ALLIANCE BRINGS TOGETHER ITS NETWORKED CRITICAL ACCESS HOSPITALS IN KANSAS AND NEBRASKA TO LEARN FROM EACH OTHER AND DEVELOP BEST PRACTICES IN CARE PROVISION, MANAGEMENT, AND GOVERNANCE. AFFILIATED HOSPITALS RECEIVE POLICY GUIDANCE REGARDING FINANCIAL ASSISTANCE TO PATIENTS, CORPORATE COMPLIANCE, CONFLICTS OF INTEREST, AND MANY OTHER AREAS. GUIDANCE IS ALSO PROVIDED TO THE GOVERNING BOARDS OF AFFILIATED HOSPITALS TO ASSIST THEM IN FULFILLING THEIR FIDUCIARY RESPONSIBILITIES. false false false false false false false false false CURT COLSON PRESIDENT/CEO 0 213766 0 0 0 3593 0 21263 0 33511 0 272133 0 0 JASON BARB CFO 0 190136 0 0 0 1277 0 18538 0 32120 0 242071 0 0 ALLEN VANDRIEL ADMINISTRATOR 189192 0 0 0 6465 0 19924 0 22562 0 238143 0 0 0 STEPHEN LEWIS CFO 136696 0 0 0 3653 0 14426 0 22515 0 177290 0 0 0 SARAH RAGSDALE Administrator 124533 0 0 0 315 0 12103 0 14177 0 151128 0 0 0 HANNAH HAACK PHYSICIAN 343342 0 0 0 390 0 32200 0 32744 0 408676 0 0 0 JUSTIN OVERMILLER PHYSICIAN 322754 0 0 0 433 0 32200 0 29830 0 385217 0 0 0 FERRILL CONANT PHYSICIAN 264253 0 0 0 5502 0 27072 0 20079 0 316906 0 0 0 STEPHEN MOLL PHYSICIAN 263744 0 0 0 283 0 26899 0 32564 0 323490 0 0 0 LEAH WIEHL PHYSICIAN 171046 0 0 0 324 0 17739 0 22831 0 211940 0 0 0 Schedule J, Part I, Line 3 FORM 990, PART VII ANNUAL COMPENSATION REVIEWS ARE COMPLETED BY THE CEO AND CHIEF FINANCIAL OFFICER USING RECOMMENDATIONS PROVIDED BY DEPARTMENT MANAGERS AND CURRENT MARKET CONDITIONS. ALL EXECUTIVE EMPLOYEE SALARIES, INCLUDING THE PRESIDENT/CEO, ARE APPROVED BY THE GPHA BOARD OF DIRECTORS. THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAS COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. THE CEO RETAINS DOCUMENTATION IN ADDITION TO THAT IN THE BOARD MINUTES. Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION THE LARGEST PROGRAM SERVICES MEASURED BY EXPENSES ARE: 1. SMITH COUNTY MEMORIAL HOSPITAL - THIS 16 BED CRITICAL ACCESS HOSPITAL PROVIDES A WIDE VARIETY OF INPATIENT AND OUTPATIENT MEDICAL SERVICES TO RESIDENTS OF THE SERVICE AREA. INCLUDED AMONG THESE SERVICES ARE THE FOLLOWING: A. INPATIENT CARE - I. ACUTE AND OBSERVATION (OUTPATIENT) CARE FOR PATIENTS WITH MEDICAL AND SURGICAL CONDITIONS. THIS INCLUDES NEONATAL, PEDIATRIC, ADULT, AND GERIATRIC PATIENTS. II. SKILLED SWING BED CARE FOR PATIENTS REQUIRING POST-ACUTE CARE, ESPECIALLY SKILLED NURSING AND REHABILITATION SERVICES. III. PRIVATE PAY CUSTODIAL CARE IS PROVIDED ON A LIMITED BASIS. MUCH OF THIS CARE IS PROVIDED TO PATIENTS WHO HAVE ELECTED HOSPICE BENEFITS BUT DO NOT HAVE FAMILY MEMBERS ABLE CARE FOR THEM IN THE HOME. B. OBSTETRICAL CARE INCLUDING PRENATAL EDUCATION, MONITORING AND DIAGNOSTIC SERVICES DURING THE PRENATAL PERIOD, AS WELL AS LABOR AND DELIVERY SERVICES DURING THE PERINATAL PERIOD. THIS INCLUDES SURGICAL CARE FOR SCHEDULED AND URGENT C SECTIONS NEEDED FOR DELIVERY. THIS AREA HAS SEEN INCREASED VOLUMES AS MANY SURROUNDING HOSPITALS HAVE DISCONTINUED OB PROGRAMS. C. EMERGENCY CARE AVAILABLE 24 HOURS PER DAY BY A STAFF OF SPECIALLY TRAINED REGISTERED NURSES, ADVANCED PRACTICE REGISTERED NURSES, PHYSICIAN ASSISTANTS, AND PHYSICIANS. ALL EMERGENCY DEPARTMENT STAFF ARE CERTIFIED IN VARIOUS TYPES OF ADVANCED LIFE SUPPORT PROGRAMS, INCLUDING ADVANCED CARDIOVASCULAR LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, AND ADVANCED TRAUMA CARE COURSES. THIS FACILITY IS CERTIFIED AS A LEVEL IV TRAUMA CENTER AND IS CERTIFIED AS A STROKE CARE CENTER. TELEHEALTH SERVICES ARE AVAILABLE IN EACH OF THE TWO TRAUMA ROOMS, CONNECTING INSTANTLY TO REGISTERED NURSES AND BOARD CERTIFIED EMERGENCY PHYSICIANS AT A DEDICATED RESPONSE CENTER IN SOUTH DAKOTA. THIS TELEHEALTH SERVICE ALSO PROVIDES EVALUATION OF PATIENTS SUFFERING FROM CRISIS LEVEL BEHAVIORAL HEALTH EMERGENCY SERVICES. D. ANCILLARY DIAGNOSTIC AND THERAPEUTIC SERVICES. THESE INCLUDE: I. LABORATORY WITH STAFF AVAILABLE 24 HOURS PER DAY TO PERFORM A WIDE VARIETY OF CHEMISTRY, HEMATOLOGY, COAGULATION, URINALYSIS, BLOOD GAS, AS WELL AS BASIC MICROBIOLOGY TESTS. BLOOD BANKING IS ALSO AVAILABLE. A CONTRACTED REFERENCE LABORATORY PERFORMS MORE COMPLEX TESTING. PATHOLOGY SERVICES ARE ALSO PROVIDED THROUGH A CONTRACTED SERVICE. II. DIAGNOSTIC IMAGING SERVICES INCLUDE DIGITAL X-RAY, CT SCAN, DIAGNOSTIC ULTRASOUND, ECHOCARDIOGRAPHY, PORTABLE FLUOROSCOPY, MAMMOGRAPHY, AND BONE DENSITY. MOBILE SERVICES PROVIDED UNDER CONTRACT INCLUDE MRI AND NUCLEAR IMAGING. III. ANESTHESIA SERVICES ARE PROVIDED IN THE EMERGENCY, AMBULATORY SURGERY, AND INPATIENT SURGICAL SETTING BY A DEDICATED CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). A SEPARATE PAIN MANAGEMENT SERVICE UTILIZING A CONTRACTED SERVICE WAS IMPLEMENTED DURING THE YEAR AND HAS BEEN EXTREMELY SUCCESSFUL. THIS SERVICE INVOLVES EVALUATION OF PATIENT NEEDS BY A SPECIALLY TRAINED APRN, WITH INTERVENTIONAL PAIN MANAGEMENT SERVICES SUBSEQUENTLY PERFORMED BY A CRNA. IV. RESPIRATORY THERAPY AND PULMONARY FUNCTION ARE AVAILABLE, INCLUDING ACUTE INPATIENT AND EMERGENCY DEPARTMENT ASSISTANCE WITH AIRWAY MANAGEMENT, SUPPLEMENTAL OXYGEN, HELIOX, AND AEROSOL THERAPY, SHORT-TERM MECHANICAL VENTILATION, AND ASSISTANCE WITH NEONATAL RESUSCITATION. V. PHYSICAL AND OCCUPATIONAL THERAPY, AS WELL AS SPEECH LANGUAGE PATHOLOGY ARE AVAILABLE FOR INPATIENT AND OUTPATIENT CARE. VI. CARDIAC AND PULMONARY REHABILITATION SERVICES ARE PROVIDED TO PATIENTS ON A SCHEDULED BASIS. PATIENTS RECOVERING FROM CARDIAC EVENTS OR SURGERY, AND PATIENTS WITH CHRONIC PULMONARY DISEASE BENEFIT FROM THESE SERVICES. VII. WOUND CARE SERVICES ARE AVAILABLE THROUGH A CONTRACT SERVICE ON A WEEKLY BASIS. GPSC MEDICAL STAFF AND NURSING STAFF FROM THE RURAL HEALTH CLINIC HELP STAFF THIS CLINIC, WHICH PROVIDES DEBRIDEMENT AND CARE FOR SLOW-HEALING WOUNDS, AS WELL AS THE APPLICATION OF SKIN SUBSTITUTE PRODUCTS TO PROMOTE HEALING. VIII. DIAGNOSTIC SLEEP SERVICES INCLUDING BOTH ATTENDED AND HOME SLEEP STUDIES AND CPAP TITRATION ARE PROVIDED UNDER A CONTRACT ARRANGEMENT. IX.DIETARY SERVICES TO INPATIENTS AND OUTPATIENTS ARE PROVIDED BY A STAFF LED BY A REGISTERED CLINICAL DIETICIAN WHO IS ALSO OUR EXECUTIVE CHEF. TAILORING OF MEALS TO MEET THE THERAPEUTIC NEEDS AND DESIRES OF OUR INPATIENTS, COUPLED WITH EDUCATION REGARDING HEALTHIER FOOD CHOICES ARE PROVIDED TO EVERY INPATIENT. THE FOOD SERVICES STAFF ALSO PROVIDE AND PACKAGE THE MEALS FOR THE MEALS ON WHEELS PROGRAM. X. OUTPATIENT SPECIALTY CLINIC SERVICES ARE PROVIDED AT THE CAH BY A WIDE VARIETY OF PROVIDERS. THESE ARRANGEMENTS ALLOW US TO OFFER SPECIALTY SERVICES TO RESIDENTS OF THE AREA WITHOUT THE NEED FOR TRAVEL TO DISTANT LOCATIONS. SERVICES PROVIDED AT SCMH INCLUDE CARDIOLOGY (3 PROVIDERS), CARDIOVASCULAR SURGERY, PULMONOLOGY, NEPHROLOGY, GENERAL SURGERY (2 PROVIDERS), PODIATRY, ORTHOPEDIC SURGERY, UROLOGY, OB/GYN, DERMATOLOGY, RHEUMATOLOGY, ENDOCRINOLOGY, BEHAVIORAL HEALTH MEDICATION MANAGEMENT, AND COUNSELING SERVICES AND THE PREVIOUSLY MENTIONED PAIN MANAGEMENT SERVICE. 2. SMITH COUNTY FAMILY PRACTICE - THIS CERTIFIED RURAL HEALTH CLINIC PROVIDES PRIMARY CARE SERVICES TO PEDIATRIC, ADULT AND GERIATRIC PATIENTS FOR A FULL RANGE OF MEDICAL CONDITIONS. STAFFED BY FIVE BOARD CERTIFIED FAMILY MEDICINE PHYSICIANS AS WELL AS PHYSICIAN ASSISTANTS AND ADVANCED PRACTICE REGISTERED NURSES. IN ADDITION TO PRIMARY CARE SERVICES DELIVERED IN THE RHC, THESE PROVIDERS STAFF THE EMERGENCY DEPARTMENT AND INPATIENT AND OUTPATIENT AREAS OF THE CAH. THEY ALSO PROVIDE SERVICES TO PATIENTS (RESIDENTS) IN SKILLED NURSING AND ICF LONG TERM CARE FACILITIES IN SMITH, OSBORNE, AND PHILLIPS COUNTIES. PHYSICIANS ALSO SERVE AS MEDICAL DIRECTORS FOR TWO SKILLED NURSING FACILITIES, FOR SMITH COUNTY EMS, AND AS THE COUNTY HEALTH OFFICER. 3. 340B PHARMACY SERVICES - GREAT PLAINS OF SMITH COUNTY, INC. UTILIZES THE 340B PROGRAM OPERATED UNDER THE AUSPICES OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO OBTAIN DRUGS AND PHARMACEUTICALS FOR USE IN THE OUTPATIENT SETTING AT SMITH COUNTY MEMORIAL HOSPITAL (THE CAH) AS WELL AS THROUGH CONTRACTED ARRANGEMENTS WITH THREE AREA RETAIL PHARMACIES. THE DISCOUNTED PRICING AVAILABLE UNDER THIS PROGRAM (ALTHOUGH UNDER THREAT CURRENTLY BY UNILATERAL ACTION BY SOME DRUG MANUFACTURERS) ALLOWS US TO OFFSET THE COST OF DELIVERY OF SERVICES WITHIN OUR SERVICE AREA. Form 990, Part VI, Line 2 BUSINESS RELATIONSHIPS CURT COLSON AND JASON BARB HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. Form 990, Part VI, Line 15a 15B - PROCESS FOR DETERMINING OFFICER COMPENSATION THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS. Form 990, Part VI, Line 6 Classes of members or stockholders GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF SMITH CO., INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS. Form 990, Part VI, Line 11b Review of form 990 by governing body THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF EXECUTIVE OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REVIEW PRIOR TO FILING THE 990 WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS, AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MISCELLANEOUS REVENUE - Total Revenue: 26587, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 26587; Form 990, Part IX, Line 11g Other Fees CONTRACTED MEDICAL STAFF - Total Expense: 3389100, Program Service Expense: 3389100, Management and General Expenses: , Fundraising Expenses: ; BILLING/COLLECTIONS - Total Expense: 627204, Program Service Expense: , Management and General Expenses: 627204, Fundraising Expenses: ; LAB SERVICES - Total Expense: 297175, Program Service Expense: 297175, Management and General Expenses: , Fundraising Expenses: ; PHARMACY SERVICES - Total Expense: 308059, Program Service Expense: 308059, Management and General Expenses: , Fundraising Expenses: ; ADMIN/HUMAN RESOURCES - Total Expense: 99992, Program Service Expense: , Management and General Expenses: 99992, Fundraising Expenses: ; MAINTENANCE/HOUSEKEEPING - Total Expense: 75857, Program Service Expense: 56865, Management and General Expenses: 18992, Fundraising Expenses: ; PLANT OPERATIONS - Total Expense: 41700, Program Service Expense: 31260, Management and General Expenses: 10440, Fundraising Expenses: ; DIETARY SERVICES - Total Expense: 575, Program Service Expense: 575, Management and General Expenses: , Fundraising Expenses: ; GREAT PLAINS HEALTH CARE FOUNDATION INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 480955870 SUPPORT KS 501(c)(3) 10 GPHA INC true GREAT PLAINS HEALTH ALLIANCE INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 480617739 MANAGEMENT KS 501(c)(3) 3 NA false GREAT PLAINS OF ELLINWOOD INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226976 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS OF OTTAWA COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226856 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS OF SABETHA COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481236156 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS OF CHEYENNE COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226831 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS OF REPUBLIC COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226977 HOSPITAL KS 501(c)(3) 3 GPHA INC true GPHA EMPLOYEE BENEFITS TRUST 250 N ROCK ROAD STE 160 WICHITA KS 67206 476918582 HEALTH PLAN KS 501(c)(9) GPHA INC true CHARITABLE REMAINDER TRUST (1) CHARITABLE TR KS GP OF SMITH CTY true CHARITABLE REMAINDER TRUST (1) CHARITABLE TR KS GP OF SMITH CTY true CHARITABLE REMAINDER TRUST (3) CHARITABLE TR KS GP OF SMITH CTY true false false false false false false false false false false true false true false true false false true false GPHA EMPLOYEE BENEFITS TRUST R 1112911 FMV